What is Meaningful Use of an EHR? An Example of How an EHR is Preventing Hospital Readmissions
Brett Coughlin | March 28, 2013
Electronic health records are essential in allowing physicians to monitor their patients’ health, notice trends, and potentially prevent hospital readmissions, quickly diagnose diseases, and reduce medical errors.
In this post, we interview a physician at a family practice to learn more about how he is meaningfully using his EHR to coordinate patient care, prevent a hospital readmission and ultimately improve patient health.
On the day we spoke, Dr. Frank Maselli of Riverdale Family Practice in the Bronx had just finished seeing 30 patients. In at 8 a.m., done by 2 p.m. It was a fairly typical day for a not-so-typical family practice.
He explains what makes it not-so-typical: one woman with chest pain, a 430-pound diabetic who wasn’t taking his disease seriously and an elderly gentleman with pneumonia who had recently been discharged from an area hospital two days earlier – a hospital where Dr. Maselli doesn’t practice.
While talking with the last patient, who is trying to recover from pneumonia, Dr. Maselli logged into the Bronx Regional Health Information Organization (Bronx RHIO), and was able to download the discharge notes for the patient. While reviewing the note, Dr. Maselli realized that the patient was not following the discharge instructions and was able to talk to him about the importance of following the discharge regimen exactly.
Maselli explains that it is just him and his wife, so there are no adult children to help him follow the regimen.
In the midst of our conversation, Dr. Maselli came to an important realization and his electronic medical record was a large part of the reason why.
EHRs Are Reducing Hospital Readmissions
It was the interaction with this patient that has led Dr. Maselli to an important realization of the importance of EHRs.
“He wasn’t taking his medications correctly. [Having an EHR] made the transition of care better… Maybe we avoided a readmission,” Maselli says.
Without electronic health records, Maselli says he is able to avoid “the usual craziness” of trying to track down the treating physician, who – since his patient was discharged two days earlier – probably isn’t going to remember the details of the admit with any clarity at this point.
“My patient’s medical records are Lord knows where, but the fact is, I was able to connect with the hospital system within 15 seconds and I was talking to my patient while I was doing this,” he says.
Case closed. The EHR assisted in preventing a hospital readmission and the patient is now taking his meds at the right intervals and he’s going home to his wife.
All of the above would not have been possible without the Riverdale Family Practice’s commitment to its electronic health record system.
Riverdale is a NCQA-approved Patient-Centered Medical Home (PCMH), level 3 and Dr. Maselli is proud of how the system has evolved. He admits there was a big investment in the system, two systems, actually. The first EHR vendor Riverdale worked with was “sold out from under them” so they paid for another one and spent some trying times learning how to use it. That turned into a partnership with the Primary Care Information Project (PCIP) of the NYC Health Department lead by then Assistant Commissioner/now National Coordinator for Health IT, Farzad Mostashari, MD. To meet the goal of level 3 NCQA PCMH, the practice needed to upgrade its software. Emblem Health put Maselli and his partners in contact with PCIP, which hooked them up with a good deal on the transition to the new software along with significant support. The net result: Riverdale met the project goals and received a bonus sufficient to cover the whole cost of the “re-install,” about $140,000.
While the transition to an electronic health record was not smooth, Dr. Maselli truly feels like it helps him reduce hospital readmissions for the patients he sees.
Stay tuned for our next blog post when we continue to answer the question, “What is Meaningful Use of EHRs?” and ask Dr. Maselli about his experience using an electronic health record for e-prescribing and how he thinks that has impacted his ability to provide quality care for his patients.
Have you used an EHR with someone who was released from a hospital? Do you think it has helped you reduce hospital readmissions? We would love to hear from you in the comments below.
The bonuses – through the city and Emblem – represented about $140,000 over two years for achieving the quality measures that were required.